In Need of Some Serious Help

Pharma / TRT Testosterone Replacement
1

Hi all.

I am 20 years old. Im 6ft and weight around 155 pounds. I’ve been battling for 2 years with depression, anxiety, brainfog, inability to concentrate etc.
I was diagnosed with low testosterone in two tests (300-350 ng/dl), overall there was three but one of them was actually normal (600 ng/dl)

I was offered a trial to try Sustanon 250 every 2 weeks to see if it improved my feeling at all.
After my 3rd injection I started getting really hot feeling on my skin (normal temperature tough), heart pounding, fast heartrate around 80-90 (my normal is around 65),
terrible migraine headaches, blue/purple toes/fingernails occasionally, really severe shortness of breath.
I went to ER atleast 3 times, every time they did ECG and found nothing. Said I was anxious, prescribed meds and sent me home.

I was really, really scared so I decided to not take the next testosterone injection. After a month, this feeling didn’t pass I read about estradiol
and went to check my E2 levels. They were in the middle of range (70 pmo/l). I retested after another month
had passed because the feeling hadn’t just stopped, it was little bit lower than before (50 pmo/l).

I went to several doctors. I had an echocardiogram and stress test, I had this very bad feeling in the chest
several days, including in the testing, but they found nothing critical. I did got diagnosed with
mitral valve prolapse and mild valve regulation, but they said this was nothing to be afraid of,
check it out again in few years. These might explain something, but I only got the heart symptoms after testosterone. I am really hopeless.

My overall feeling is like I am about to have heart attack or something at any time, but it has
been like this for several months now. Lately I’ve been sweating a lot, feeling really nauseous and overall just really sick.
I then suspected hyperthyroid, but fT3 and fT4 are both midrange (they were in the very upper range before tough.)
And my TSH has gone from hoovering around 2 to 0.65 in just few months, but this wasn’t any cause of action to doctors neither.

So other suspicion was E2 levels, but apparently bloodtest shows them normal.
My AM cortisol (bloodtest) was high normal last autumn , but now it was midrange.
Prolactin was normal according to doctor. Lowish Vitamin D and B12 was found.
I also suspected blood clot because of the shortness of breath, but they took the bloodtest
twice which would show if I had one and it was negative. And also I am still alive two months after that so obivously
it cant be blood clot or anything?

I just feel that something is really messed up inside my body and causing me to feel very, very ill. The worst thing is, I don’t know what is the cause. Something is wrong, causing all these horrible symptoms. Im having this intense chest tightness all the time
and redness in the face, along with the feeling of really hot. My skin also burns occasionally. Heart pounding is really awful feeling and I am feeling weaker. Occasionally I get some pain around kidney region,
but both my kidney and liver tests were fine. Also this weird pressure in my head all the time. At one point I had so bad migraine that I had to go into IV meds in hospital to stop the attack. I don’t know what the heck I am going to do next.

My symptoms are very very scary but so far nothing has been diagnosed. Also my eyes are sometimes red and feels dry.
What would be the next course of action? Could it still be high E2 even tough bloodtest
says nothing? Could I just be really sensitive to estradiol changes? This situation is obiviously putting some kind of stress on my body as
i’ve seem to have some circulation problems and fast heartrate which cant be healthy for prolonged time and this has
already been little over 3 months this way.

I’ve scheduled an appointment to endorcrinologist
end of this month but I feel like I can’t handle this anymore. Besides, so far my hormone levels
have been in the acceptable range. But this is not normal feeling by any means. Any advice? I bought some DIM, but haven’t
tried it yet. I read that it can lower E2 levels. Could this help even tough my E2 is “ok” by bloodtest?

'Cause what I have been reading, these could be symptoms of high E2 and I can’t see any other possible reasong for how I am feeling. Im going to call my doc next week when he will be available but he can’t prescribe me an A.I if my E2 levels says normal, can’t he?.. This can’t go on for much longer, my skin is really hot all the time and I feel 5x worse than before. Any suggestions please?

Oh, and one more thing is, how I am suspecting estradiol is that I have seem to put on a little bit of breast tissue. There is tiny lumps under my nipples, I can feel them. But why the heck is my E2 level showing normal? All help is gladly appreciated.

2

These are the required labs, you have most now.
TT
FT
E2
LH/FSH <== very important and should have been done before any TRT
DHEA-S
prolactin
TSH
fT3, fT4
rT3 - increases with stress, inflammation etc and blocks fT3 making one hypo
CBC
fasting glucose
fasting cholesterol [might be too low]
AM cortisol - at 8AM
CRP - general inflammation marker
homocysteine - marker for inflammatory processes in the arteries
vit-D25

Were testes physically examined? Testicular cancer is a young man’s disease.

Check your overall thyroid function:
Get oral body temperature when you first wake up and also mid-afternoon. Should be 97.7-98.8 in AM, 97.3 is really too low and you need 98.6 in afternoon

Would you say that you have unexplained weight loss and/or rashes?
Any aches pains?
Testes ache?

When TSH dropped, might you have introduced iodized salt and/or vitamins that list iodine?
Is your thyroid sore, enlarged, lumpy or asymmetrical?

Please read these stickies:

  • things that damage your hormones
  • advice for new guys
  • thyroid basics

When a young guy has these problems, one needs to treat low-T as a symptom and not the problem and find the root cause.
If LH/FSH is low, prolactin is tested to see if that is a cause and a MRI can confirm a pituitary adinoma. But some adinomas are not prolactin secreting. If FSH is high, this can be from a FSH secreting testicular tumor or, rarely, a FSH secreting pituitary adinoma.

Please post lab results in list format with lab ranges.

Please respond to all points above, double check.

1 Like
3

I will be posting lab values etc soon. As of right now I have a question.

So my E2 are within normal range, but experiencing symptoms of high E2. I also have some small lumps under my nipples and developed slight breast tissue. This could be due to first starting TRT then stopping cold turkey after 3 shots (250mg E10-14D), caused some hormonal changes? Does E2 also affect circulation? My fingernails and toes are occasionally slight bluish color, this wasn’t the case before.

Anyway, my doc said that the E2 test might not be that accurate as it is designed for women mainly. He prescribed me some generic anastrozole to be taken 0.5mg E3D. This is the best I can do right now. Can I try this and see if symptoms leave? Will post all lab values etc tomorrow.

4

Blue fingernails: This is poor blood circulation. Check blood pressure. Have you started to notice hearing your own pulse. CBC lab work will be helpful, especially hematocrit [HTC]. Do not ignore this!!!

Please post labs in a list format with ranges.

Your nipples and breast tissue respond to both the effects of E2 and prolactin. Both should be tested in young males with lower T, especially when LH/FSH are low. There can easily be some transient effects on the nipples as well as you suggested.

5

I stopped TRT at the early days of April 2015.
TT:
Last summer, year ago: 330 ng/dl (ref. about 300-1000)
Last autumn: around 600 ng/dl
March 2015: 280 ng/dl (started TRT trial after this)
Two months after stopping after 3 injections: 360 ng/dl
FT: Free T measurements was calculated methods with SHBG:
March 2015: (SHBG was 32 nmo/l) 150 pmo/l (200-580)
Latest: (SHBG was 20 nmo/l) 190 pmo/l
E2: One month after discontinuing injections: 0.07 nmo/l (ref range is <0.15 nmo/l
Two months after: 0.05 nmo/l
LH/FSH: Last summer: 4.5 U/l (ref. range 2.5-7 U/l)
Two months after discontinuing injections 3.3 U/I
FSH was around 2 last summer (ref. range around 1.5-12)
FSH was normal according my doc just recently, but didn’t say number.
DHEA-S - Has not been measured.
prolactin: Has been hovering around 120-250 m/UI, ref range being 50-300
TSH: Always been hovering around 2. After two months after discontinuing TRT it was 0.67, ref range is 0.4-4.5 mU/l
fT3, fT4: Both of these were at the very high end of ref range last summer.
two months after discontinuing TRT:
fT4: 14.5 pmo/l (9-21 pmo/l)
fT3: 5.1 pmo/l (3.5-6.5 pmo/l)
rT3 - I actually had poor rT3/T3 ratio and I was treated with T3 only for about 3 months. I had to stop taking it same time the existing symptoms appeared. I tought it had made me hyperthyroid.
CBC: Taken also two months after discontinuing TRT. All was perfectly in range, except for low’ish platelets: 123 E9/l (150-360 E9/L), they have always been around this area.
Hemoglobin: 146 g/l (134-167 g/l)
Hematocrit: 46% (39-50%)
fasting glucose: 5.3 nmo/l (4-6 nmo/l)
fasting cholesterol: total cholesterol: 5.3 mmol/ (<5 mmo/l
HDL: 1.8 mmo/l (>1 mmo/l
LDL: 3.1 mmo/l (<3 mmo/l)
AM cortisol - This was at the very high end of range when taken last autumn.
June 2015: 330 nmo/l (150-650nmo/l) Is this too low for AM? Doc said normal.
CRP - Sensitive CRP: <3 mg/l (<3 mg/l)
homocysteine - not taken
vit-D25: 50 nmo/l (>40nmo/l, recommended over 80 nmo/l) Supplementing with 100 micrograms of vitamin D every day now.

Also got liver and kidney function bloodtests, they were all normal.

My blood pressure, when measured at doctors was pretty high: 150/80. When measured at home it has seemed quite normal recently, altough diastolic can sometimes go to 50’s. When measured at home, it has been 130/80 to 115/55 area.

Were testes physically examined? Year ago, yes. Nothing suspicious.

Check your overall thyroid function: Will do this tomorrow and update it on this spot.

Would you say that you have unexplained weight loss and/or rashes?: After the symptoms appeared few months ago, along with the overall feeling of being hot, especially in the chest, I had some itchiness around upper body. I’ve lost around 4 pounds in the past 3 months. Other symptoms includes excessive sweating, occasional pressure around head, sometimes dizziness, signs of poor circulation and occasional shortness of breath. Also heart pounds really hard and/or beats a tad too fast occasionally.
Any aches pains?: Not really
Testes ache?: not really

When TSH dropped, might you have introduced iodized salt and/or vitamins that list iodine? - Nope.
Is your thyroid sore, enlarged, lumpy or asymmetrical? - Hard to say if its enlarged, but it was examined by doc and he said it seemed normal size. I’d say it feels quite normal.

Please read these stickies:

  • things that damage your hormones
  • advice for new guys
  • thyroid basics

What should I do with these symptoms? Seems like they got 3x worse when starting TRT, then stopping. I suspected high E2 was to blame but somehow my tests say normal, altough I do have symptoms that would indicate otherwise. Before I only suffered from lethargy, erection difficulties, brainfog, low libido and slight depression and anxiety. Now I also have these physichal symptoms with heartrate and circulation. I just want to go back to starting line.

6

When labs were done on TRT, what was you protocol and dosing schedule and lab timing relative to that?

7

Well I was only on TRT for 3 injections. The time span was barely a month in. My doc said to take injections E10-E14D. I started at the very end of March, stopped very end of April. I think I took the shots E12D. So it was whole ampoule of Sustanon 250. First labs were scheduled to be 2 months after starting TRT, but as I got these very scary symptoms only month in, I never did the first labs, until I was off TRT already. Im still feeling incredibly hot especially on my upper body and face. My heart sometimes pounds really fast while doing nothing and I get sweaty. Heart echocardiogram has only diagnosed mitral valve prolapse. Don’t know if I had that always, but atleast the symptoms only started after the TRT.

What does my midrange 8AM cortisol tell to you? Is it too low? What should be the next step?

8

Any advice?

I took my temperature this morning 7AM, it showed 35.5 celsius aka. 96F, this seems concerning.
Around 12PM it was 36.1 celsius aka. 97F

Blood pressure has been pretty good, latest measure was 116/66.

Still experiencing same symptoms, feeling very hot, especially in the upper body area. Heart is pounding pretty often. A lot of these symptoms really indicate E2 issues, but bloodtest does only tell me normal.

I did 4 samples cortisol saliva test and also going to test my Testosterone and DHEA levels tomorrow. I noticed the doc actually put “DHEA” test, I think I am going to ask it to be changed to DHEA-S when I go tomorrow.

Would really like to get this away, the feeling of hot is especially really annoying. It seems to get worse when anxious/stressed.

Here is also some more info:

-age - 20
-height - 6ft
-waist - 30 inches
-weight - 155 lbs
-describe body and facial hair - only few chest hairs around nipples, not much facial hair, light and grows pretty slowly
-describe where you carry fat and how changed - around abdomen region
-health conditions, symptoms [history] - diagnosed with low testosterone via bloodtest, however been once in normal range.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
– real dangers! see this http://propeciahelp.com/overvi… - nope
-lab results with ranges - posted already
-describe diet [some create substantial damage with starvation diets] - healthy home food, eat 4-5 times a day, vegetables and fruits daily.
-describe training [some ruin there hormones by over training]: No energy to do much anything besides going out for a walk. Went to gym for about 6 months little over year ago, seemed to only make me worse.
-testes ache, ever, with a fever? - negative
-how have morning wood and nocturnal erections changed - getting nocturnal erections 0-1 times per day. morning wood not often.

9

Okay. I just got some more bloodwork recently. Symptoms still exists, the hot skin sensation is really, really awful and its been going now for 5 months, along with heart palpitations etc. Skin seems drier than normal too and for example when I take blood pressure, the skin area where the cuff is turns very red, also my chest feels occasionally rashy and red.

I had been 2 week on anastrozole 0.5-1mg a week prescribed by doctor to see if my symptoms improve while I took this bloodwork. My E2 however was normal according the bloodwork so I don’t know. Haven’t had any significant improvement with this. However, I got some really interesting bloodwork.

SHBG: 38.10 nmo/l (17-66) - little higher than before
Testosterone total: 20.8 nmo/l (10-38) so this turns to be around 600 ng/dl which is perfectly fine. However, now I don’t know if it was because of the anastrozole or if it just naturally returned to normal and my early low results were normal variations and due to stress. I did have one normal result earlier too. So I don’t think I need to look back at the TRT, seems like my levels have recovered to normal. I will however need to take it again after ceasing anastrozole. So obiviously by this bloodwork, testosterone is not PROBABLY the concern.
Testosterone free, calculated: 54.6 (15-95)

Here is cortisol tests:
Bloodwork was done 8am:

Cortisol: 392 nmo/l (138-690) ← seems perfectly normal…

HOWEVER, here is where I think things are starting to get interesting: I also took 4 sample saliva cortisol test the day before my bloodwork. Here are the results:

7-8AM (took around 7:30): 1,87 nmo/l (1,38-15,7)
12-13PM (took around 12pm): 8,55 nmo/l (0,55-9,94)
16-17PM (took around 17pm): 4,1 nmo/l (0,55-6,62)
22-23PM (took around 23pm): 1,18 nmo/l (0,55-3,59)

So obiviously saliva test gave me totally different result in the AM than bloodtest. They were took different days though. But I read that saliva test measure better the actual bioavailable amount of cortisol? Ain’t the morning number in that case quite borderline low? But could it explain all these crazy symptoms?

I also took DHEA. They accidentally took DHEA and not DHEA-S, so I still have to wait few days to get the DHEA-S result. Here is however DHEA:

DHEA: 22.5 nmo/l (4.6-27)

What does these results tell? Should I in future test something more? The endo I went called me and said theses were all fine and didn’t see any reason for further testing.

I still get occasionally crippling pain in the lower back area. My eyes sometimes feel dry and I get headaches. Also I am sweating pretty hard. Sometimes I feel like my heart actually stops for few seconds and then continues and sometimes my heart rhytm goes weird for a while. Im still yet to see my 24-hour heart monitor results.

Any insight?

10

I don’t think that you responded to my question about use of iodized salt?

Thyroid feels or appears abnormal? Sore?

Ever had AST/ALT checked?

CBC and hematocrit?

What is current state of unexplained weight loss?

Back pain is lower left?right?central

11

I am sorry, I missed that question, but about iodized salt; nope, did not make any dietary changes regarding iodine consumption during that time. By the way, my new TSH test came back recently and it was 1.4

Thyroid feels or appears abnormal? Sore?: Not sore, feels normal and doctor said it feels normal too.

Ever had AST/ALT checked?: yep perfectly normal

CBC and hematocrit?: Everything was perfectly normal except little low platelet count, platelets were around 125,000/mcL, ref range being 150,000-450,000. Hematocrit was 45% reference range being 38-50%

What is current state of unexplained weight loss?: Havent lost anymore weight, I think it was/is because of lowered appetite after all this hassle.

Back pain is lower left?right?central: I think it varies, today morning I felt the pain on little more the right side and little later it seemed to come from the left side.

12

A massage therapist may be able to help with back pain.

Blood pressure and blue fingernails [bad circulation].

  • DHEA if DHEA-S low
  • fish oil
  • mini aspirin
  • higher T
  • lower E2
  • vit-D3
  • anti-oxidants
  • vitamin K1/K2 or dark green leafy veges

Perhaps your low pulse was not normal and you are having trouble with normal pulse rates. Suggests that arteries, are not compliant, expanding with blood pulses, then the muscles contract. The muscles have to be able to relax to expand with the pulses of blood. B est if you can get your thyroid in order, but that can also quicken/restore pulse.

13

Yeah something weird is going on with my body right now for sure. Is the saliva AM cortisol normal? Shouldn’t it be towards the higher end?

How much fish oil should I take? I am currently taking 3 caps a day regular fish oil caps.

Is L-Arginine any good with the circulation issues?

14

Fish oil: Not all the same. Some are more active ingredients and less fat.

15

Greetings, it has been awhile. I did small dose anastrozole for about 3 months, then quit. I’ve been now off of it for about 3 months. After discontinuing it, I have been experiencing hairloss, increased anxiety and occasionally nightsweats, also feeling a bit of breast tissue, also my hands and feet feel really cold from time to time. I did some bloodwork just while ago and got quite interersting results, if you don’t mind looking at them. Having a meeting with doctor in about a month. Supplements I have been taking: magnesium citrate, zinc, fish oil, vitamin B-complex and calcium.

My body temperature has been around 96.8 F upon waking up for the past couple of days I’ve been measuring.

These were taken at 8am after 7 hours of sleep:

Leukocytes: 5.1 E9/l (3.4-8.2)
Hemoglobin: 155 g/l (134-167)
Hematocrit: 0.45 (0.39-0.5)
MCV: 94 (82-98)
MCH 32 (27-33)
Thrombocytes 114 E9/l (150-360) LOW [has always been low, why?]

Growth Hormone: 0.15 ug/l (0-3) [Pretty low, near zero?]
ACTH: 64 ng/l (7-63) - HIGH
Cortisol: 386 nmo/l (172-497)
ALAT: 14 U/l (<50)
K, potassium: 3.3 nmo/l (3.3-4.8)
Na, sodium: 143 nmo/l (137-144)
Creatinine: 79 umol/l (60-100)

TSH: 3.5 mU/l (0.5-4.3)
fT4: 17 pmo/l (12.6-21)
fT3: 4.8 pmo/l (3.9-7.7)

LH: 4.1 U/l (1.7-8.6)
E2: 0.085 nmo/l (0-0.13) [was 0.05 before, E2 rebound from discontinuing anastrozole?]
IGF1: 52 nmo/l (18-91)
Testosterone total: 11 nmo/l (10-38)
SHBG: 37 nmo/l (15-48)
Free calculated testosterone: 165 pmo/l (190-560) LOW
Testosterone/SHBG ratio: 297 (410-1400) LOW

So quite a few abnormal readings… any insight?

16

Any toughts regarding my labwork? Would really appreciate it :slight_smile:

17

I think that you’re running three or four conditions together, and you might get more traction by handling them separately.

  1. The red, itchy skin could be hives. This can be triggered by allergies or stress. Try a generic, over-the-counter antihistamine. These work well for me. Your red eyes might also be allergy related.
  2. The tightness breathing could be a panic attack, and related to depression and anxiety.
  3. And your lab results look like low T.

TRT might help with depression and anxiety, but the other things probably need looking at individually.

18

Thanks for chiming in! Anyone have any idea why my platelets have been low on all of the bloodwork I’ve had in the recent years? Also what might be contributing to the sudden hairloss? Didn’t lose hair before when I had low T, after stopping my arimidex experiment scalp started itching and hairloss occurring… could it be the ratio of E2/Testosterone? Low GH? Thyroid?

Also what does the high ACTH tell?

19

Little update, been measuring my blood pressure and it seems rather low. Today it was around 90-105/44-55…

Don’t really have any symptoms except rather strong heartbeat. Going to monitor it some more. Got a meeting with endrocrinologist in 2 weeks now.

20

man Im sorry to hear that, The same thing happened to me a week a go I felt I was going to die, thought that was it, It really sucks cause I still dont know what caused it, have you worked it out already, or did you stop the treatment, I think Im gonna stop it since the sides are not worth it, I’ll continue it until I find a competent doctor, let me know if you could solve the problem! Thank you!